Occupational Physicians Withdraw Support for Ergo Standard

Despite the fact that the American College of Occupational and Environmental Medicine (ACOEM) was an original supporter of OSHA's ergonomics standard, the major medical association now opposes the final standard.

Despite the fact that the American College of Occupational and Environmental Medicine (ACOEM) was an original supporter of OSHAs ergonomics standard, the major medical association now opposes the final standard.

ACOEM becomes the only major medical association previously supporting the standard to withdraw its support, citing the standards lack of sound medical foundation.

We cannot support the final regulation as it is currently written, said ACOEM President Dr. Robert Goldberg, and director of ErgoUC with the Ergonomics Program and assistant clinical professor at the University of California, San Francisco.

He expressed ACOEMs fear that in its haste to publish the final standard, OSHA has put the standard in legal jeopardy by the agencys failure to address the shortcomings debated during hearings earlier this year.

During those hearings, ACOEM submitted several recommendations to establish a firm medical basis for the diagnosis and treatment of musculoskeletal disorders.

Throughout the past two years of the rulemaking process, ACOEM said it has consistently urged OSHA to limit implementation of the standard only to work-related disorders for which credible scientific evidence exists.

Yet, the final standard appears to require neither a medical diagnosis nor a casual assessment, said ACOEM.

This standard is certain to be held up by legal battles for the next several years, said Goldberg. Unfortunately, OSHAs failure to base the standard on firm medical foundation lends credence to the argument that will be made in court by those who will try to block this standard from going into effect. It is distressing that our nations workers will be left without preventive measures to protect them from unnecessary musculoskeletal injuries.

ACOEM said, that while it was pleased OSHA included an appeals process for temporary work restrictions and work removal, the College is disappointed that the standards multiple review requirement fails to provide for health care providers who have the ability to make a diagnosis or casual assessment or who have any knowledge of the prevention and treatment of musculoskeletal disorders.

The College pointed to other programs, such as the OSHAs lead, arsenic and asbestos standards, that base their work restrictions and removal requirements on a medical diagnosis.

ACOEM also pointed out some shortcomings in some of the terminology used in the standard.

The standard simply lists several specific disorders but fails to specify the criteria for a determination of a musculoskeletal disorder, said ACOEM. Absent a physician or other health care provider qualified to make a diagnosis, OSHA fails to define the signs, symptoms and diagnostic testing data that would lead a healthcare provider to support the diagnosis of musculoskeletal disorder."

In light of the anticipated lawsuits from both labor organizations and private industry, ACOEM said it is hopeful that the courts will resolve these issues, resulting in a stronger and more enforceable ergonomics program standard.

We would support any action that will correct the errors and omissions present in this standard, said Goldberg. Throughout the rulemaking process, ACOEM has supported the development of an ergonomics standard, but in the end, this final standard does not address the concerns we raised. ACOEM has no choice but to oppose the final standard.

By Virginia Sutcliffe

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